Development of Nursing Practice in Accordance with Advance Directive for Old Persons with Dementia in Nursing Homes

这项研究的目的是描述根据养老院老年痴呆症患者预先指示进行临终关怀的细节和方法。我们通过问卷调查了日本各地养老院的护理管理者，发现从养老院中的痴呆症老人那里获得提前指示的努力非常罕见。此外，对25名护士管理人员关于他们协助临终关怀的成功经验的访谈表明，他们清楚地了解如何“收集护理规划所需的信息”，“应老年人的要求应用预先指示”，以及“反思他们如何才能做得更好”。

The objective of this study is to describe details and methods of end-of-life care in accordance with advance directive for old persons with dementia in nursing homes. We surveyed nurse administrators of nursing homes throughout Japan through questionnaire, and found that efforts to obtain advance directive from elderly persons with dementia in nursing homes are very rare. Moreover, interviews with 25 nurse administrators about their successful experiences assisting with end-of-life care showed a clear understanding on how they can"collect information necessary for care planning", "apply the advance directive as requested by the elderly person", and "reflect on how they could have done a better end-of-life care".